Imaging in Coronary Interventions

Coronary angiography has historically served as the gold standard for diagnosis of coronary artery disease and guidance of percutaneous coronary intervention (PCI), but the evolution of PCI would not have been possible without intravascular imaging which provides unique insights about coronary artery pathology.

Over the last 30 years IVUS and, more recently, optical coherence tomography (OCT) have been extensively used to examine the extent and severity of coronary artery disease (CAD), guide PCI in complex lesions, and assess the performance of emerging devices introduced to treat CAD. In this section, you will find a selection of resources showing the use of imaging in real-life scenarios.

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Can’t stand heavy metal: how to treat an ACS with severe metal allergy?

17 Mar 2025

Francesco Costa

Author

Francesco Costa

Author

Antonio Muñoz Garcia
Alberto Piserra

Author

Alberto Piserra

Author

Juan Horacio Alonso Briales
Can’t stand heavy metal: how to treat an ACS with severe metal allergy?

Impact of intravascular imaging guidance on percutaneous coronary intervention of severely calcified lesions: The ECLIPSE trial

29 Mar 2025

Aaysha Cader provides her take on the ECLIPSE trial presented by Gregg W. Stone at ACC.25 in Chicago.

Author

Aaysha Cader
Impact of intravascular imaging guidance on percutaneous coronary intervention of severely calcified lesions: The ECLIPSE trial

Functional or anatomical assessment of non-culprit lesions in acute myocardial infarction

06 Mar 2025

This study demonstrates that OCT-defined TCFA is a superior prognostic marker compared to μQFR for assessing NCLs in AMI patients.

Alessandro Sticchi

Reviewer

Alessandro Sticchi
Functional or anatomical assessment of non-culprit lesions in AMI

Comprehensive diagnosis in chronic coronary syndromes combining angiography and intracoronary testing: the AID-ANGIO study

18 Feb 2025

The authors hypothesized that enriching invasive coronary angiography (ICA) with an advanced invasive diagnosis (AID) strategy would increase the diagnostic yield of obstructive and non-obstructive coronary artery disease (INOCA).

Ruxandra Sava

Reviewer

Ruxandra Sava
Nicola Ryan

Reviewer

Nicola Ryan
Comprehensive diagnosis in CCS combining angiography and intracoronary testing AID-ANGIO study

Computed tomography versus near-infrared spectroscopy for the assessment of coronary atherosclerosis

17 Feb 2025

NIRS-IVUS offers precise assessment of coronary artery pathology but is invasive and limited in scope, while CCTA is emerging as a non-invasive alternative for comprehensive plaque evaluation.

Reviewer

Christian Said
Nicola Ryan

Reviewer

Nicola Ryan
Computed tomography versus near-infrared spectroscopy for the assessment of coronary atherosclerosis

Precision PCI in the era of AI and multimodality imaging

13 Jan 2025

Nailing the ostium of LAD, although technically challenging, can be precisely done with mandatory intracoronary imaging. It is essential to rule out disease extension into left main artery as, otherwise, cross over LM-LAD stenting strategy would be preferable. CTCA can help the interventionist plan the PCI,...

Fawaz Bardooli

Author

Fawaz Bardooli
Tajammul Hussain Hakimuddin

Author

Tajammul Hussain Hakimuddin
Precision PCI in the era of AI and multimodality imaging

Complicated subendothelial dissection during left anterior descending coronary artery – first diagonal branch bifurcation treatment with Culotte technique

06 Jan 2025

Learn more about troubleshooting and tailor-made treatment combining 2D and 3D OCT thanks to this image in cardiology!

Troubleshooting of a complicated subendothelial dissection using 2D and 3D OCT

Stepwise OCT for treatment optimization in provisional approach of bifurcated coronary lesions

10 Jan 2025

OCT provides information of the accuracy of every maneuver performed during the treatment of bifurcation lesions. We can clearly see if the POT achieves proximal stent apposition, if the side branch wire crosses through the correct cell, and the impact of final kissing-balloon inflation on stent geometry.

Javier Suarez de Lezo

Author

Javier Suarez de Lezo
Stepwise OCT for treatment optimization in provisional approach of bifurcated coronary lesions

Left main bifurcation instent restenosis - LIVE case

18 Dec 2024 – From GulfPCR-GIM 2024

A 76-year-old male with a history of LM PCI (2-stent strategy), RCA PCI, reduced LV function (25%), diabetes, and CKD presented with worsening angina. Angiography revealed in-stent restenosis at the ostium of the LAD and CX, along with RCA occlusion.

The procedure was performed with axillary Impella...

Left main bifurcation instent restenosis  - LIVE case

Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial

04 Nov 2024

The aim of this pre-specified analysis of the ILUMIEN IV trial was to assess the relationship between post-PCI OCT parameters of suboptimal stent implantation and clinical outcomes.

Rick Volleberg

Reviewer

Rick Volleberg
Nicola Ryan

Reviewer

Nicola Ryan
Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial